Provider Demographics
NPI:1861422396
Name:KING, STEVEN J (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:KING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 FIELDSTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:AL
Mailing Address - Zip Code:35117-4628
Mailing Address - Country:US
Mailing Address - Phone:205-285-2095
Mailing Address - Fax:205-285-2093
Practice Address - Street 1:2001 FIELDSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35117-4628
Practice Address - Country:US
Practice Address - Phone:205-285-2095
Practice Address - Fax:205-285-2093
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20022207R00000X, 208000000X, 2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009937111Medicaid
AL051534023OtherBLUE CROSS PROVIDER #
AL009937111Medicaid